Abstract

Cerebral venous thrombosis (CVT) is an uncommon condition, but its clinical presantation is varied and often dramatic. It often affects young-to-middle-aged patients, and more commonly women. We report a woman aged 26 years, who had a sudden onset of a persistent severe headache 30 days ago. She underwent a non-focal neurological examination, except bilateral papilledema. Magnetic resonance imaging disclosed no abnormalities. Magnetic resonance venography (MRV) of the head demonstrated recanalized sagittal sinus thrombosis. Hematological studies confirmed the diagnosis of protein S deficiency. The patient was treated with low-molecular-weight heparin, had no further neurologic deterioration and discharged on 15th day. A CVT, although not common, should be considered in atypical cases (patients with persistent severe headache, or associated seizure activity), or in patients with potential hypercoagulable states. An MRV is the diagnostic mode of choice. Anticoagulation seems to be safe and efficacious.